Summer Camp Ends August 4th - registration for last week of camp is CLOSED

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in

2017 APV Summer Camp Registration Form

Please note that all fields followed by an asterisk must be filled in.

First Name*

Last Name*

E-Mail Address*

Street Address*

City*

State/Prov*

Zip/Postal Code*

Home Phone*

Student's Name*

Age *

School

Please list ADA Accommodations needed

Single Day Camper-Please specify Date

Extended Day Hours 6:30am-7:00pm (Additional $25/week)

YES, I wish to sign my child up for the extended camp hours

NO, I do not wish to sign my child up for the extended camp hours

Camp Rotations - Please choose 2:*

Acting Lessons

Music/Dance Lessons

Art Instruction

Cooking/Nutrition

Approved Child Pick Up (Please list first and last names)

Emergency Contact (Please list names, phone numbers, and relation)

Transportation To and From Camp*

Total Fees Due

Payment in full by June 2nd - Payment Type

Check

Cash

Online

Statement of Understanding*

By checking this box I accept and understand that there are 9 weeks of OPMI Summer Camp ($65/per week) beginning June 5th - August 4th. Summer Day camps are from 7:30am-6:00pm, Extended drop off and pick up are from 6:30am-7:30am and 6:00pm-7:00pm which has an additional cost of $25. For a single summer day camp registration (drop off/pick up) the daily fee is $32.50. There will be a onetime registration fee of $20 upon the first week of summer camp sign up. Any portion of the camp that my child cannot attend shall be forfeited without refund or credit. I also understand that I am responsible for picking up my child from camp on time. If I am more than 10 minutes late, I accept and understand that fees will be applied. I also understand that any belongings I send my child to camp with are the responsibility of my child and OPMI nor the Association of Poinciana Villages is responsible for lost, damaged, or stolen items.